Government Health Insurance Schemes in India: Complete Guide

The government has established several health insurance schemes to provide quality healthcare facilities to people. These schemes are regularly updated to prevent delays in accessing healthcare services. They raise awareness about medical issues, ensure adequate infrastructure, and promote various health-related facilities.

What is a Government Health Insurance Scheme?

A government health insurance scheme is a health insurance plan funded by the State or Central Government for its citizens. These schemes offer affordable policies with substantial coverage, aiming to improve the medical standards within the state. Annually, various schemes are introduced to address healthcare needs.

It is the State government's responsibility to develop a robust health plan to ensure public well-being. In India, numerous health insurance policies have been implemented to bridge the healthcare and insurance gap, particularly in rural areas. Examples of government health insurance schemes in India from recent years include Ayushman Bharat, Awaz Health Insurance Scheme, Aam Aadmi Bima Yojana, Bhamashah Swasthya Bima Yojana, and many more.

Regular Health Insurance Plans vs Government Health Insurance Scheme

There is a difference between regular health insurance plans and government health schemes in India. These differences can be tracked regarding features, eligibility, coverage, and several other factors. 

Types of Government Health Insurance Scheme

Below are the types of Government Health Insurance Schemes offered by the government to improve the healthcare sector of the country. 

1. Ayushman Bharat: The Ministry of Health and Family Welfare has introduced the Ayushman Bharat Yojana, a universal health insurance scheme designed to provide free healthcare services to over 40% of the population in India. With coverage up to ₹5 lakh, this scheme includes expenses for diagnosis, medicines, pre-hospitalization costs, and medical treatments.
2. Awaz Health Insurance Scheme: This health insurance scheme was initiated by the Government of Kerala to provide healthcare coverage for migrant workers. Under this scheme, the healthcare coverage is ₹15,000, and in the case of death, it provides coverage of ₹2 lakh.
3. Central Government Health Scheme: This scheme, initiated by the Central Government of India, is designed for central government employees and their families. Covering over 35 lakh employees and pensioners, it has been active for the last six decades. The policy includes coverage for hospitalization and domiciliary care, and benefits a wide range of individuals, including Supreme Court judges and Railway Board employees. It encompasses both allopathy and homoeopathy treatments.
4. Employees’ State Insurance Scheme: Launched in 1952, this insurance scheme provides coverage for illness, disability, and death of insured workers and employees. Originally started in Kanpur and Delhi, the policy has expanded nationwide over time. In 2015, several updates were made to enhance its coverage and benefits.
5. Chief Minister’s Comprehensive Insurance Scheme: This insurance policy is promoted by the Government of Tamil Nadu in association with United India Insurance Company Ltd. It is a family floater plan designed to provide reliable health care insurance. Under this scheme, hospitalisation expenses can be claimed up to ₹5 lakh. It is available to residents of Tamil Nadu who earn less than ₹75,000 a year.

Features and Benefits of Government Health Insurance Schemes

There are several features and benefits of Government Health Insurance Schemes. A few have been listed below:   

1. These health insurance policies are offered at a low price for people who have a low income. 
2. These insurance policies are also available to people with low incomes or those who are below the poverty line. 
3. Policyholders can be assured of reliable coverage, as these policies are offered by both the Central and state governments.
4. Some selective government plans have no lifetime limits on essential health benefits, ensuring ongoing care without restrictions.
5. Providing security for the policyholders, the government health insurance policies offer comprehensive health benefits. 
6. Promoting wellness among the citizens, these health plans offer free prevention care which includes cancer screening, immunization, etc. 
7. Some health plans by the government offer treatments at private hospitals for upgraded healthcare facilities. 

Conclusion

The government health insurance schemes play a crucial role in expanding the healthcare sector in India. They offer security and financial protection to the underprivileged, ensuring access to medical care for every citizen in India. While these schemes may not always cover as comprehensively as private health insurance plans, they provide significant benefits that can cover medication and treatment costs.

These government-sponsored health insurance policies are set to continue offering vital healthcare benefits to lower-income groups for years to come. To access these policies, individuals should verify their eligibility and select a plan that best fits their needs. Government-aided health insurance policies are both secure and affordable, making them a viable option for middle-class families.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the Insurance industry and products. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.